Contract Analyst III

Location: Columbus, OH
Joining this team means you'll be surrounded by colleagues who are dedicated to meeting their own high standards, to inspiring their teammates and to making a positive impact on under-insured and uninsured individuals. The group is a fast, agile, customer-focused organization with a commitment to implementing the latest technologies.
 
Our client serves more than 55 million managed care members through their portfolio of high-quality commercial and government sponsored healthcare programs. The broad offering of programs that they provide has helped them to build both capacity and capability to successfully navigate a changing healthcare environment, while continuing to offer better health outcomes at lower costs.
 
Position Purpose:
Provide analytic support for network performance, unit cost trend, network profiling and evaluation, and contract modeling for current health plans, future business, and new products. Utilize applications and tools to support network performance management reporting and analytic needs.
 
Job Description:
  • Support the design and development of applications to project and determine financial impact for contract negotiations for health plans, national contracting opportunities (hospital, physician, and ancillary) and impact of statewide rate changes
  • Support the design and development of enhanced analytic capabilities and tools to monitor and evaluate financial impact of changes in reimbursement terms with providers and statewide rate changes for health plans
  • Prepare network performance management reports to monitor and measure unit cost trends and network improvement opportunities
  • Identify, define, and implement improvements in the methods, standards and processes to better enable constructing enterprise and stand-alone applications Identify and quantify cost of care savings opportunities, recommend strategies to achieve targeted results, and provide analytic support for health plans Identify potential source data enhancements and business rule changes needed to produce the business information expected as a result
  • Research trends in provider reimbursement and strategy to improve unit cost performance Evaluate alternative reimbursement methodologies to improve unit cost management for current and future business opportunities
  • Collaborate with health plans to evaluate analytic needs for contracting modeling and evaluation to support contract negotiations
  • Support existing application solutions, develop enhancements requested by the business, and identify technical enhancements to improve stability, performance and quality of the outcome
 
Qualifications:
Education/Experience:
  • Bachelor's degree in Business, Finance, Accounting, related field, or equivalent experience.
  • 4+ years experience with provider reimbursement and analysis, application development, data/contract analysis and data mining or statistics, preferably in the healthcare industry.
  • Intermediate knowledge of Access and Excel applications.
  • Working knowledge of SQL tools, analytical software (SAS, SPSS, etc), and Business Objects/Cognos preferred.
 
Licenses/Certifications:
  • N/A
 
Our client offers options that allow you to do more than just plan for retirement. Their programs allow shared success with employees.
  • 401(k) with company match
  • Employee stock purchase plan
  • Training and Learning Opportunities/Tuition Reimbursement/Educational Assistance
  • On-site fitness center or discount at local fitness centers (most locations)
  • Discounts for select local and national products and services, including cell phones, computers and more
  • Other amenities may be available, but vary by location
 
Equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
 
 
 
April A. Estes
Senior Recruiter
720-439-2609 Direct
april@proenlist.com 
www.proenlist.com 
www.medenlist.com 
https://www.indeedjobs.com/proenlist?hl=en_US
 
 
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